Cancer doctors urged to consider value when treating patients

CHICAGO (Reuters) - Cancer doctors should consider the
financial as well as the medical impact of treatment for
patients as healthcare costs continue to grow faster than the
overall economy, according to experts in Chicago at the annual
meeting of the world's largest organization of oncologists.

The American Society of Clinical Oncology is developing a
system to rate drugs for advanced cancer based on a combination
of benefit, side effects and price. The cost of such drugs can
easily run into tens of thousands of dollars a year, even though
many have been shown to extend the lives of later-stage cancer
patients by just a few months.

"The problem is that the current system is unsustainable
because it threatens access to high-quality cancer care," said
Dr. Neal Meropol, chief of hematology and oncology at University
Hospitals Case Medical Center in Cleveland.

The price issue has led some doctors to balk. In April 2013,
more than 100 leukemia specialists complained in the American
Society of Hematology's journal "Blood" that cancer drug prices
were "too high, unsustainable, may compromise access of needy
patients to highly effective therapy and are harmful to the
sustainability of our national healthcare systems."

Insurers are looking to partner with doctors to reduce the
chance of unnecessary spending.

"There are therapies that have high value and there are
therapies that may not have much value," said Lee Newcomer, a
senior vice president at UnitedHealth Group Inc.

He noted insurance companies' motives are viewed with
suspicion when it comes to deciding whether a treatment is
cost-effective, so having ASCO play a key role in establishing
such guidelines would be crucial to their implementation.

Gregory Rossi of AstraZeneca stressed that any conversation
about the value of cancer drugs needs to take into account the
benefits of new, targeted cancer drugs that are based on an
understanding of the biology of cancer.

"There are things we can do today that were unable to do a
few years ago," Rossi said.

Rossi said drug companies should be rewarded for meaningful
innovation.

But former Obama health adviser Dr. Ezekiel Emanuel had
little sympathy for that argument.

"Everyone wants continued innovation," he said, while noting
that the price of some cancer drugs, such as Novartis' Gleevec,
have tripled since they first reached the market despite the
launch of new competitors.

He noted that Gilead Sciences Inc has taken a lot of flack
for its $84,000-per-treatment drug for hepatitis C infection,
even though it cures the disease.

"Seems like a good value to me," he said. "One-time
treatment over a few months and yet we are having a lot of
consternation because of the cost."

Cancer doctors, he suggested, need to do much more to
consider both the volume and the price of the treatments and
tests they prescribe for patients.